Basic Information
| Provider Information | |||||||||
| NPI: | 1992856710 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LEW | ||||||||
| FirstName: | DOLORES | ||||||||
| MiddleName: | JEAN | ||||||||
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| NameSuffix: | SR. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2 CONVENT RD | ||||||||
| Address2: | KELLIGAR HOUSE | ||||||||
| City: | MORRISTOWN | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 079606923 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9732905324 | ||||||||
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| Practice Location | |||||||||
| Address1: | 703 MAIN ST. | ||||||||
| Address2: | |||||||||
| City: | PATERSON | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 07503 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9737542240 | ||||||||
| FaxNumber: | 9737542244 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/16/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363A00000X | 25MP000109 | NJ | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant |
No ID Information.